Arthur Laurens Bruce, DMD
Individual provider Active NPI General Practice Dentistry · Pendleton, SC
NPI 1154475283 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1154475283
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 2093 (SC)
- Practice address
- 896 S Mechanic Street
Pendleton, SC 29670 - Phone
- (864) 646-7152
- Fax
- (864) 646-7112
- NPI assigned
- Jan 23, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140329000273 | SC | Order and Referring Only - Dentist |
8224269576 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arthur L. Bruce, DMD | Past | Accepting new patients | |
| Bruce Family Dental LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2093 | SC | Yes |
Addresses
Primary practice location
896 S Mechanic Street
Pendleton, SC 29670
Mailing address
896 S Mechanic Street
Pendleton, SC 29670
Phone (864) 646-7152
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Z20932 | Medicaid | SC |
Other providers in Pendleton, SC
- Charlotte Anne Grover Branyon
- Niquesha Brown
- Rodrell S. Brown
- Teresa Lynn Brown
- Bruce Family Dental LLC
- Deborah Cantrell
- Kazzandra Day Collier
- Brooke Colvin
- Joan Schnell Comen
- Comfort Companions
All providers in Pendleton, SC · General Practice Dentistry in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.